What is the medication treatment (tx) for binge eating disorder?

From the Guidelines

The most effective medication treatment for binging is a serotonin reuptake inhibitor, such as 60 mg fluoxetine daily, which should be prescribed either initially or if there is minimal or no response to psychotherapy alone by 6 weeks of treatment. According to the American Psychiatric Association practice guideline for the treatment of patients with eating disorders 1, adults with bulimia nervosa should be treated with eating disorder-focused cognitive-behavioral therapy and a serotonin reuptake inhibitor. Some key points to consider when treating binging with medication include:

• The use of antidepressant medication or lisdexamfetamine for adults with binge-eating disorder who prefer medication or have not responded to psychotherapy alone 1
• The importance of combining medication with psychotherapy, such as cognitive behavioral therapy (CBT), for optimal results
• The need for regular monitoring by healthcare providers to assess effectiveness and manage side effects
• The potential for individual responses to vary and the need for trial and adjustment to find the right medication. In terms of specific medications, options may include:
• Fluoxetine (Prozac) at 60mg daily
• Lisdexamfetamine (Vyvanse) at 30-70mg daily
• Other SSRIs or antidepressant medications, as recommended by the American Psychiatric Association 1.

From the FDA Drug Label

In the controlled clinical trials of fluoxetine supporting its effectiveness in the treatment of bulimia nervosa, patients were administered fixed daily fluoxetine doses of 20 or 60 mg, or placebo (see CLINICAL TRIALS). Only the 60–mg dose was statistically significantly superior to placebo in reducing the frequency of binge–eating and vomiting Consequently, the recommended dose is 60 mg/day, administered in the morning.

The recommended medication treatment for binging is fluoxetine at a dose of 60 mg/day. This dosage has been shown to be effective in reducing the frequency of binge-eating and vomiting in patients with bulimia nervosa 2.

From the Research

Medication Treatment for Binge Eating

• The primary medication treatment for binge eating disorders, including bulimia nervosa (BN) and binge eating disorder (BED), involves the use of selective serotonin reuptake inhibitors (SSRIs) 3, 4, 5, 6, 7.
• SSRIs are considered the first-line choice for treating BN and BED due to their effectiveness in reducing binge eating episodes and their tolerability by patients 3, 4, 5.
• Studies have shown that SSRIs, such as fluoxetine and citalopram, can significantly reduce binge eating and purging episodes in patients with BN and BED 4, 6.
• Other medications, such as topiramate, have also been found to be effective in reducing binge eating in patients with BN and BED, particularly in those who do not respond to SSRIs 3, 5.
• Combination therapy, involving the use of multiple medications, may be necessary for optimal outcomes in some patients 5.
• The choice of medication may depend on the individual patient's symptoms and response to treatment, with some medications being more effective for certain symptoms, such as depression or anxiety 6.

Comparison of Medications

• A study comparing fluoxetine and citalopram found that both medications were effective in reducing binge eating and improving psychopathology, but had different efficacy profiles 6.
• Fluoxetine was found to be more effective in reducing introjected anger, while citalopram was more effective in reducing depressive feelings 6.
• Topiramate has been shown to be effective in reducing binge eating in patients with BN and BED, but may have side effects that limit its usefulness 5.
• Other medications, such as zonisamide and atomoxetine, have also been found to be effective in reducing binge eating in patients with BED, but more research is needed to confirm their efficacy 5.